Weight Loss Strategies and the Risk of Skeletal Muscle Mass Loss

Abstract

With energy intake restriction and exercise remaining the key diet and lifestyle approaches to weight loss, this is not without potential negative implications for body composition, metabolic health, and quality and quantity of life. Ideally, weight loss should be derived almost exclusively from the fat mass compartment as this is the main driver of metabolic disease, however, several studies have shown that there is an accompanying loss of tissue from the fat-free compartment, especially skeletal muscle. Population groups including post-menopausal women, the elderly, those with metabolic disease and athletes may be particularly at risk of skeletal muscle loss when following a weight management programme. Research studies that have addressed this issue across a range of population groups are reviewed with a focus upon the contribution of resistance and endurance forms of exercise and a higher intake dietary protein above the current guideline of 0.8 g/kg body weight/day. While findings can be contradictory, overall, the consensus appears that fat-free and skeletal muscle masses can be preserved, albeit to varying degrees by including both forms of exercise (but especially resistance forms) in the weight management intervention. Equally, higher intakes of protein can protect loss of these body compartments, acting either separately or synergistically with exercise. Elderly individuals in particular may benefit most from this approach. Thus, the evidence supports the recommendations for intakes of protein above the current guidelines of 0.8 g/kg body weight/d for the healthy elderly population to also be incorporated into the dietary prescription for weight management in this age group.

Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management

“…Indeed, its peculiar composition, with its caloric intake provided mainly by complex carbohydrates, and protein content derived mainly from vegetable and dairy sources and not exceeding 1 g/kg of body weight, could affect its efficacy in the extent and duration of weight loss. Moreover, the scarce amount of high-quality animal proteins needed to balance the muscle catabolism physiologically induced by CR, and the presence of high levels of carbohydrates, although complex, could not allow activating efficient lipolysis and fat mass reduction (103). Particularly, in settings of insulin resistance/altered glucose metabolism, conditions strictly interconnected with obesity, a high dietary carbohydrate/protein ratio is not favorable both from a metabolic point of view and in inducing weight loss (104,99).…”

“…Obese patients with CKD do not make an exemption. This is the reason why, when planning a CR, it is necessary to raise protein intake above the recommended value of 1 g/kg to spare muscle mass (103). The problem becomes more complex in the CKD setting, when protein restriction is usually required, especially in later stages.…”

Home-Based HIIT and Traditional MICT Prescriptions Improve Cardiorespiratory Fitness to a Similar Extent Within an Exercise Referral Scheme for At-Risk Individuals

“…Interestingly, the MICT group demonstrated a significant reduction in muscle mass post-intervention, though this reduction was not maintained at follow-up. It is unclear why this reduction was observed as previous work suggests MICT does not affect muscle mass and has been suggested as a potential addition to dietary weight management programs to preserve muscle mass ( McCarthy and Berg, 2021 ). However, dietary records were not collected which makes interpretation of body composition data difficult.…”

Ambulante Gewichtsreduktion durch Mahlzeiten-Ersatz-Therapie in der ärztlichen Praxis: 2-Jahres-Ergebnisse einer nicht kontrollierten Beobachtungsstudie

“…Studien belegen, dass bei einer Reduktion des über- schüssigen Körperfetts auch eine Abnahme der FFM zu bemerken ist. Im Allgemeinen besteht der typische Verlust an Gesamtkörpergewicht aus 20-40 % FFM, der Rest stammt aus der FM [56]. Somit stellt sich die Frage, ob es einen "akzeptablen" Anteil der Gewichtsabnahme gibt, der durch die FFM Abnahme bedingt ist.…”